1.Successful in situ 5-aminolevulinic acid photodynamic therapy in a 53-year-old female with cutaneous squamous cell carcinoma.
Limin LUO ; Xiaoling JIANG ; Jianjun QIAO ; Hong FANG ; Jun LI
Journal of Zhejiang University. Science. B 2025;26(9):915-922
Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), as certain forms of non-melanoma skin cancer (NMSC) or keratinocyte carcinoma, are the most common forms of malignant neoplasms worldwide (Sharp et al., 2024). BCC and cSCC have been identified as two major components of NMSC, comprising one-third of all malignancies (Burton et al., 2016). Generally speaking, patients with NMSC tend to have relatively favorable survival outcomes, while different histopathological subtypes of NMSC exhibit distinct biological behaviors (Stătescu et al., 2023). Keratinocyte carcinoma, although not considered as deadly as melanoma, tends to metastasize if left untreated (Civantos et al., 2023; Nanz et al., 2024). cSCC can evolve locally, then aggressively metastasize, invade, and even lead to fatal consequences in a subset of patients (Winge et al., 2023). A solid, pigmented, smooth plaque or a hyperkeratotic papule with or without central ulceration and hemorrhage appears to be characteristic of cSCC (Thompson et al., 2016; Zhou et al., 2023). Of note, a rare type of intraepidermal cSCC in situ often appears as a velvety, demarcated, slightly raised erythematous plaque on the genitalia of men (Yamaguchi et al., 2016). Accounting for approximately 16.0% of scalp tumors and with a rising incidence, cSCC is now the second most common NMSC in humans (Verdaguer-Faja et al., 2024). According to the latest statistics, up to 2%‒5% of cSCCs in situ may gradually progress into invasive cSCCs in the final step (Rentroia-Pacheco et al., 2023). Several risk factors for the carcinogenesis and development of cSCC have been identified, including age, accumulative exposure to ultraviolet light radiation A and B, human papillomavirus infection, arsenic ingestion, chronic scarring, xeroderma pigmentosa, a relevant history of ionizing radiation, androgenetic alopecia in males, and immunosuppression therapy (Martinez and Otley, 2001; Welsch et al., 2012; Mortaja and Demehri, 2023).
Humans
;
Aminolevulinic Acid/therapeutic use*
;
Skin Neoplasms/pathology*
;
Photochemotherapy/methods*
;
Female
;
Carcinoma, Squamous Cell/pathology*
;
Middle Aged
;
Photosensitizing Agents/therapeutic use*
;
Carcinoma, Basal Cell/drug therapy*
2.Expression of NFAT5 and IGF1R in nasopharyngeal carcinoma tissues and analysis of clinical characteristics.
Jie YANG ; Qing WANG ; Fusheng LIN ; Lin GAO ; Ran ZHANG ; Xingqian ZHAO ; Xiaojiang LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):333-343
Objective:To investigate the expression of NFAT5 and IGF1R in nasopharyngeal carcinoma tissues and analyze their expression levels in relation to clinical features and prognosis. Methods:From January 1, 2019, to December 31, 2019, 69 cases of nasopharyngeal carcinoma tissues and adjacent non-cancerous tissues were collected from patients treated at Yunnan Cancer Hospital. Immunohistochemistry was employed to detect the expression of NFAT5 and IGF1R in nasopharyngeal carcinoma tissues. The Kaplan-Meier method was used to predict survival time, and the clinicopathological features were evaluated using the log-Rank test. Results:The positive expression rates of NFAT5 and IGF1R in nasopharyngeal carcinoma tissues were 87.0% and 84.5%, respectively. Compared to adjacent normal tissues, the expression levels of NFAT5 and IGF1R in nasopharyngeal carcinoma tissues were significantly increased (P<0.05). Furthermore, the expression of NFAT5 and IGF1R was positively correlated with T stage, N stage, skull base invasion, and cranial nerve palsy (P<0.05). The overexpression of NFAT5 and IGF1R significantly affected the survival rate of patients with nasopharyngeal carcinoma and was negatively correlated with prognosis (P<0.05). Conclusion:In nasopharyngeal carcinoma tissues, overexpression of NFAT5 and IGF1R is observed, which is closely linked to clinical features and patient outcomes. These markers may serve as valuable indicators for predicting the prognosis of nasopharyngeal carcinoma.
Humans
;
Nasopharyngeal Carcinoma/pathology*
;
Nasopharyngeal Neoplasms/metabolism*
;
Prognosis
;
Female
;
Receptor, IGF Type 1/metabolism*
;
Male
;
Transcription Factors/metabolism*
;
Middle Aged
;
Survival Rate
;
Adult
;
Neoplasm Staging
3.Curcumin-loaded nanoparticles reversed radiotherapy-triggered enhancement of MDR1 expression of CNE-2 cells in nasopharyngeal carcinoma.
Guoqing ZENG ; Nan LIAO ; Ning LI ; Gaixia ZHANG ; Yi SU ; Jiangshun SONG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):351-356
Objective:This study explored the effect of nanoparticle-encapsulated curcumin on the highly expressed multidrug resistance gene 1 (MDR1) in a human low-differentiated nasopharyngeal carcinoma cell line (CNE2). Methods:Curcumin/chitosan deoxycholic acid nanoparticles were prepared, and the cells were subjected to different treatments: radiotherapy, empty carriers, curcumin, and curcumin-loaded nanoparticles. Cell survival was analyzed using the clonogenic assay, and assessments of apoptosis, MDR1 levels, and miR593 levels were conducted. Results:The cell survival fractions in the curcumin group and the curcumin-loaded nanoparticles group were significantly reduced. Notably, higher apoptosis rates were observed in cells treated with curcumin or curcumin-loaded nanoparticles compared to those that received only radiotherapy. Moreover, a decreased MDR1 level was noted in both the curcumin group and the curcumin-loaded nanoparticles group, with further reduction in MDR1 expression observed in the nanoparticle group (P<0.05). Enhanced expression of miR593 was found in the curcumin group and the curcumin-loaded nanoparticles group, with a relatively higher level in the nanoparticle group (P<0.05). Curcumin encapsulated in nanoparticles exhibited a stronger radiosensitizing effect. The combination of curcumin and radiotherapy effectively inhibited nasopharyngeal carcinoma (NPC) tumor growth, suppressed MDR1 expression, and enhanced miR593 levels. After inhibiting miR593, MDR1 expression increased. The radiosensitizing effect of curcumin-loaded nanoparticles was regulated by miR593 rather than being triggered by MDR1. Conclusion:Curcumin-loaded nanoparticles mediated enhanced expression of miR593, which in turn inhibited the transcription and translation of the MDR1 gene, thereby reducing the radioresistance of NPC and effectively restraining its growth.
Humans
;
Curcumin/pharmacology*
;
Nasopharyngeal Neoplasms/pathology*
;
Nasopharyngeal Carcinoma
;
Nanoparticles
;
Cell Line, Tumor
;
Apoptosis/drug effects*
;
MicroRNAs
;
ATP Binding Cassette Transporter, Subfamily B
;
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism*
;
Cell Survival
4.Expression of SLC7A11, GPX4 and ACSL4 in nasopharyngeal carcinoma and their correlation with radiotherapy resistance.
Donghui YAN ; Yanyan ZHENG ; Ningxiang ZENG ; Hongxun GONG ; Yanqiu HUANG ; Maoxin WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(5):462-469
Objective:To explore the correlation between ferroptosis-related proteins SLC7A11, GPX4, ACSL4 and the radiosensitivity and prognosis of nasopharyngeal carcinoma. And to investigate the potential of these proteins as molecular markers for predicting the radiosensitivity of nasopharyngeal carcinoma. Methods: A retrospective analysis was conducted on 52 cases of nasopharyngeal carcinoma (nasopharyngeal carcinoma group) and 20 cases of chronic nasopharyngiti s(control group). The relevant clinical data were reviewed, and paraffin-embedded tissue blocks were collected for study. The expressions of SLC7A11, GPX4, and ACSL4 in pathological specimens were detected by immunohistochemical staining. The expression differences of ferroptosis-related proteins between the nasopharyngeal carcinoma group and the control group were analyzed. The nasopharyngeal carcinoma group was further divided based on the protein expression levels into high and low expression subgroups for SLC7A11, GPX4, and ACSL4. Subsequently, a differential analysis of clinical data and survival analysis was conducted for each of these subgroups. Finally, logistic regression analysis was performed to identify the factors influencing radiotherapy resistance in nasopharyngeal carcinoma. Results:①The differential analysis revealed that, compared to the control group, the nasopharyngeal carcinoma group exhibited significantly higher expression of SLC7A11 and GPX4, and lower expression of ACSL4 (P<0.05). ②Notably, the proportion of patients displaying radioresistance was higher in the SLC7A11 and GPX4 high expression groups compared to their respective low expression groups (P<0.05). However, the proportion of radioresistance in the ACSL4 high expression group was lower than that in the ACSL4 low expression group (P<0.05). Survival analysis indicated that the 5-year overall survival rate was lower in the SLC7A11 and GPX4 high expression groups compared to their respective low expression groups(P<0.05). However, the 5-year overall survival rate of the ACSL4 high expression group was higher than that of the ACSL4 low expression group(P<0.05). ③logistic regression analysis showed that SLC7A11 and GPX4 was an independent risk factor for radioresistance in patients with nasopharyngeal carcinoma(P<0.05). Conclusion:Nasopharyngeal carcinoma tissues over-express SLC7A11, GPX4, and under-express ACSL4. Over-expression of SLC7A11 and GPX4 are independent risk factors for radioresistance in patients with nasopharyngeal carcinoma. The inhibition of ferroptosis may be related to the occurrence, progression and radioresistance of nasopharyngeal carcinoma. Detection of the expression of SLC7A11, GPX4, and ACSL4 has guiding significance for the evaluation of radiosensitivity and prognosis of patients with nasopharyngeal carcinoma.
Humans
;
Nasopharyngeal Carcinoma/radiotherapy*
;
Nasopharyngeal Neoplasms/pathology*
;
Coenzyme A Ligases/metabolism*
;
Radiation Tolerance
;
Phospholipid Hydroperoxide Glutathione Peroxidase
;
Amino Acid Transport System y+/metabolism*
;
Prognosis
;
Long-Chain-Fatty-Acid-CoA Ligase
;
Retrospective Studies
;
Ferroptosis
;
Male
;
Female
;
Middle Aged
5.Integrated imaging and clinical features of glottic squamous cell carcinoma of the larynx: pathological association and prognosis assessment.
Yuqiao ZHANG ; Wulin WEN ; Fengxia YANG ; Dongke MA ; Xueliang SHEN ; Ningyu FENG ; Xixi LI ; Zhiling ZENG ; Zhipeng MI ; Xiyuan YAN ; Ruixia MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):709-716
Objective:To explore the clinical, imaging, and pathological features of glottic squamous cell carcinoma of the larynx and their relationship with prognosis. Methods:A retrospective analysis was conducted on the clinical, imaging, and pathological data of 130 patients with glottic squamous cell carcinoma of the larynx who were treated at the First People's Hospital of Yinchuan and the General Hospital of Ningxia Medical University from January 2018 to March 2023. Imaging examinations (CT and MRI) were used to evaluate the lesion boundary clarity, density, enhancement nature, and enhancement degree. Postoperative pathological examination was used to determine the pathological nature, immunohistochemistry, etc. Statistical methods such as χ² test, Spearman correlation analysis, multivariate logistic regression analysis, and Kaplan-Meier method were used to analyze the data. Results:Among the 130 patients, 127 were male and 3 were female, with an average age of (61.92±9.595) years. There was a correlation between clinical, imaging, and pathological features. Multivariate analysis showed that heterogeneous MRI density (OR=12.414;P=0.019) and squamous cell carcinoma as a subtype were correlated. The initial symptom of non-hoarseness (HR=6.045;P=0.010) and unclear MRI boundary (HR=12.559; P=0.029) were independent risk factors for poor prognosis in patients with glottic squamous cell carcinoma of the larynx. Conclusion:There is a correlation between the clinical, imaging, and pathological features of patients with glottic squamous cell carcinoma of the larynx, and they can affect prognosis. The initial symptom of non-hoarseness and unclear MRI boundary of the tumor are independent risk factors for poor prognosis.
Humans
;
Laryngeal Neoplasms/diagnosis*
;
Prognosis
;
Male
;
Female
;
Retrospective Studies
;
Middle Aged
;
Carcinoma, Squamous Cell/diagnosis*
;
Magnetic Resonance Imaging
;
Glottis/pathology*
;
Tomography, X-Ray Computed
;
Aged
6.A rare case report of moderately differentiated adenosquamous carcinoma in the parotid gland associated with IgG4-related disease and literature review.
Huarong PANG ; Qiuping LU ; Zhangmo HUANG ; Jiejun YANG ; Qingyun XIE ; Biru ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):749-753
Objective:To explore the clinical manifestations of IgG4-related diseases(IgG4-RD) complicated with moderately differentiated adenosquamous carcinoma of the parotid gland, the diagnostic criteria for IgG4-related diseases and parotid malignant tumors, treatment regimens, and the application of fine-needle aspiration in disease diagnosis, so as to reduce clinical misdiagnosis and missed diagnosis. Methods:A retrospective analysis was conducted on the case data of a patient with IgG4-related diseases(IgG4-RD) complicated with moderately differentiated adenosquamous carcinoma of the parotid gland admitted to our department in March 2024. The clinical characteristics, imaging findings, preoperative puncture results, and postoperative pathological features were analyzed, and relevant literatures on both diseases were reviewed and summarized. Results:The elderly male patient was admitted due to "a mass in the parotid area in front of the right ear for more than 3 months". Through clinical examination, imaging examination, laboratory examination, and preoperative needle biopsy, the diagnosis of "right parotid moderately differentiated adenosquamous carcinoma complicated with IgG4-related disease" was considered. It was also considered that IgG4-related disease did not involve other organs before surgery, so no systemic hormone therapy was given before or after surgery. After surgery combined with postoperative radiotherapy, follow-up showed that neither the parotid tumor nor IgG4-related disease recurred. Conclusion:"IgG4-related disease complicated with moderately differentiated adenosquamous carcinoma"is a rare clinical disease. Both lack typical clinical manifestations and specific imaging features, and the diagnosis is mostly unclear before surgery. Pathological examination is of great significance in the diagnosis of the disease, while fine-needle aspiration has limited value in the diagnosis, which should attract the attention of clinicians. In addition, for patients with both diseases, individualized treatment plans should be formulated.
Humans
;
Parotid Neoplasms/pathology*
;
Male
;
Carcinoma, Adenosquamous/pathology*
;
Immunoglobulin G4-Related Disease/complications*
;
Parotid Gland/pathology*
;
Retrospective Studies
;
Aged
;
Biopsy, Fine-Needle
;
Immunoglobulin G
7.Results of active surveillance of clinical progression in low-risk papillary thyroid microcarcinoma: a single center prospective cohort study.
Xian YOU ; Dongyu LI ; Xiaoyan ZHANG ; Xinggen ZENG ; Cheng CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):836-841
Objective:To observe the clinical progression of low-risk papillary thyroid microcarcinoma(LR-PTMC), analyze the influencing factors of its oncological outcomes, and explore the feasibility of active surveillance(AS) of LR-PTMC. Methods:This study adopted a prospective observational research design. A total of 85 subjects diagnosed with LR-PTMC during health checkup in Health Management Center of our hospital from March 2021 to October 2022 were enrolled as the research subjects, for at least 2 years of AS follow-up observation. The clinical progress and oncological outcomes were recorded, disease progression was defined as any increase in nodule diameter ≥3 mm or the appearance of new lesions or lymph node metastasis or distant metastasis, and the oncological outcome was use disease progression defining. Cox proportional hazards regression model was used to analyze the influencing factors of oncological outcomes in LR-PTMC patients. Results:A total of 85 LR-PTMC patients who underwent physical examinations were included in this study. The median follow-up time was 2 years, and a total of 23 patients(27.06%) experienced disease progression. Among them, 18 patients(21.18%) had enlarged lesions(any nodule diameter increased by ≥3 mm), and 5 patients(5.88%) had abnormal or metastatic cervical lymph nodes. The 2-year cumulative disease progression rate was 9.41%. The incidence age of LR-PTMC patients was younger, with a higher proportion of ≤45 years old. The proportion of baseline nodules with a maximum diameter greater than 5 mm is higher, and the proportion of baseline TPO Ab positivity was higher. Ultrasound showed a higher proportion of microcalcifications compared to the non progression group, and the differences were statistically significant(all P<0.05). Multivariate Cox proportional hazards regression analysis showed that age of onset ≤45 years RR 95% CI 1.052(1.018-1.088) and ultrasound showing microcalcifications RR 95% CI 3.361(1.379-8.194) were independent risk factors affecting disease progression during AS in LR-PTMC patients(P<0.05). Conclusion:Most LR-PTMC patients maintain stable lesion size and low lymph node metastasis rate during the AS process, with good oncological outcomes in the short term. AS can be considered as a safe and effective alternative to surgical treatment for LR-PTMC patients. But for patients with onset age ≤45 years and microcalcifications, the follow-up interval can be shortened for close observation.
Humans
;
Thyroid Neoplasms/pathology*
;
Disease Progression
;
Prospective Studies
;
Carcinoma, Papillary/pathology*
;
Female
;
Male
;
Middle Aged
;
Adult
;
Watchful Waiting
;
Lymphatic Metastasis
;
Proportional Hazards Models
;
Risk Factors
8.Development and validation of a nomogram for predicting cervical lymph node metastasis based on hematological parameters and clinicopathological characteristics in patients with laryngeal squamous cell carcinoma.
Shanshan TIAN ; Yu SONG ; Ningyuan WANG ; Jianqiang LI ; Wenwen CHEN ; Deli WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(10):949-956
Objective:To explore the predictive value of preoperative peripheral hematological parameters combined with clinicopathological features for cervical lymph node metastasis(CLNM) in patients with laryngeal squamous cell carcinoma(LSCC), and to construct and validate a nomogram model for CLNM. Methods:A retrospective analysis was conducted on the clinical data of 264 LSCC patients who underwent surgical treatment and were pathologically confirmed, collected from the Second Affiliated Hospital of Shandong First Medical University and Taian 88 Hospital. Specifically, 161 patients from one hospital were allocated to the training cohort, while 103 patients from another hospital constituted the validation cohort. Based on postoperative pathological results, patients were categorized into CLNM-positive and CLNM-negative groups. The general clinical data, clinicopathological features, and hematological parameters of the two groups were analyzed and compared. A preoperative predictive model for CLNM was developed using logistic regression analysis, followed by validation and sensitivity analysis to evaluate the robustness of the model's predictive performance. Results:The results showed that there were significant differences in tumor location, tumor size, tumor differentiation, neutrophil percentage, lymphocyte count, lymphocyte percentage, c-reactive protein(CRP), fibrinogen, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), systemic immune-inflammation index(SII), systemic inflammation response index(SIRI), and prognostic inflammatory index(PIV) between the CLNM-positive and CLNM-negative groups(P<0.05). Lasso regression identified tumor location, clinical T stage, tumor size, tumor differentiation degree, red blood cell distribution width(RDW) -coefficient of variation(RDW-CV), CRP, FIB, D-dimer, NLR, and lymphocyte-to-monocyte ratio(LMR) were the most predictive parameters. Multivariate logistic regression revealed that tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients(P<0.05). A nomogram was constructed based on these five factors. The model demonstrated excellent discrimination, with a C-index of 0.837(95%CI 0.766-0.908) in the training cohort and 0.809(95%CI 0.698-0.920) in the validation cohort. Calibration curves and DCA curves in both cohorts confirmed the clinical utility of the model. Sensitivity analysis further supported the robustness of the results, showing good discrimination and calibration across different age and BMI subgroups. Conclusion:Tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients. The nomogram based on these variables exhibits strong discrimination, calibration, and clinical applicability, and may serve as a valuable tool for preoperative risk assessment and individualized treatment planning.
Humans
;
Nomograms
;
Laryngeal Neoplasms/blood*
;
Retrospective Studies
;
Lymphatic Metastasis
;
Carcinoma, Squamous Cell/blood*
;
Lymph Nodes/pathology*
;
Male
;
Female
;
Middle Aged
;
Neck
;
C-Reactive Protein
;
Aged
;
Logistic Models
;
Neutrophils
;
Prognosis
9.The influence of microvessel density and microlymphatic vessel density on prognosis in hypopharyngeal carcinoma and the construction.
Cong XU ; Lanzhen CUI ; Xiaoxiao LIU ; Jing BAI ; Lijun ZHANG ; Yu PENG ; Xiaoming LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(12):1143-1149
Objective:This study aims to investigate the influence of microvessel density(MVD) and microlymphatic vessel density(MLVD) on the prognosis of patients with hypopharyngeal squamous cell carcinoma(HPSCC) and to develop a nomogram prediction model for prognosis based on pathological characteristics. Methods:A retrospective analysis was conducted on clinicopathological and follow-up data from HPSCC patients who underwent surgical treatment at our institution between June 2010 and June 2020. Immunohistochemical staining was performed on tumor tissues and adjacent normal margin tissues to evaluate MVD and MLVD. The associations among MVD, MLVD, and clinicopathological features were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors affecting overall survival(OS). Based on these findings, a nomogram model was constructed and its predictive accuracy was assessed using C-index, receiver operating characteristic(ROC) curve, and calibration curve. Results:Both MVD and MLVD were significantly higher in HPSCC tumor tissues compared to normal tissues. Patients in the high MVD and high MLVD groups exhibited significantly lower OS rates than those in the low MVD and low MLVD groups. Multivariate Cox regression analysis revealed that N stage, recurrence, nerve invasion, lymph node capsule invasion, MVD, and MLVD were independent prognostic factors of OS. Based on these factors, a nomogram prognosis model was successfully constructed. The nomograms demonstrated superior performance in terms of C-index, area under the ROC curve, and calibration, outperforming the AJCC TNM staging system. Conclusion:Elevated MVD and MLVD levels are associated with poorer prognosis in HPSCC patients. The nomogram model based on pathological features provides valuable insights for clinical assessment and decision-making.
Humans
;
Hypopharyngeal Neoplasms/blood supply*
;
Prognosis
;
Retrospective Studies
;
Microvascular Density
;
Nomograms
;
Lymphatic Vessels/pathology*
;
Male
;
Female
;
Middle Aged
;
Carcinoma, Squamous Cell/blood supply*
;
Microvessels/pathology*
;
Lymphatic Metastasis
;
Survival Rate
10.Single-cell analysis identifies PI3+S100A7+keratinocytes in early cervical squamous cell carcinoma with HPV infection.
Peiwen FAN ; Danning DONG ; Yaning FENG ; Xiaonan ZHU ; Ruozheng WANG
Chinese Medical Journal 2025;138(20):2615-2630
BACKGROUND:
Cervical squamous cell carcinoma (CESC), the most common subtype of cervical cancer, is primarily caused by the high-risk human papillomavirus (HPV) infection and genetic susceptibility. Single-cell RNA sequencing (scRNA-seq) has been widely used in CESC research to uncover the diversity of cell types and states within tumor tissues, enabling a detailed study of the tumor microenvironment (TME). This technology allows precise mapping of HPV infection in cervical tissues, providing valuable insights into the initiation and progression of HPV-mediated malignant transformation.
METHODS:
We performed the scRNA-seq to characterize gene expression in tumor tissues and paired adjacent para-cancerous tissues from four patients with early-stage CESC using the 10× Genomics platform. The HPV infection and its subtypes were identified using the scRNA data and viral sequence mapping, and trajectory analyses were performed using HPV+ or HPV- cells. Interactions between different types of keratinized cells and their interactions with other cell types were identified, and pathways and specificity markers were screened for proliferating keratinized cells. The Cancer Genome Atlas (TCGA) dataset was used to verify the prognostic correlation between tumor-specific PI3+S100A7+ keratinocyte infiltration and CESC, and the localization relationship between PI3+S100A7+ keratinocytes and macrophages was verified by immunofluorescence staining.
RESULTS:
Various types of keratinocytes and fibroblasts were the two cell types with the most significant differences in percentage between the tumor tissue samples and paired adjacent non-cancerous tissue samples in the early stages of CESC. We found that PI3+S100A7+ keratinocytes were associated with early HPV-positive CESC, and PI3+S100A7+ keratinocytes were more abundant in tumors than in adjacent normal tissues in the TCGA-CESC dataset. Analysis of clinical information revealed that the infiltration of PI3+S100A7+ keratinocytes was notably higher in tumors with poor prognosis than in those with good prognosis. Additionally, multiplex immunofluorescence analysis showed a specific increase in PI3+S100A7+ expression within tumor tissues, with PI3+S100A7+ keratinocytes and CD163+ macrophages being spatially very close to each other. In the analysis of cell-cell interactions, macrophages exhibited strong crosstalk with PI3+S100A7+ proliferating keratinocytes in HPV-positive CESC tumors, mediated by tumor necrosis factor (TNF), CCL2, CXCL8, and IL10, highlighting the dynamic and tumor-specific enhancement of macrophage-keratinocyte interactions, which are associated with poor prognosis and immune modulation. Using CIBERSORTx, we discovered that patients with high infiltration of both PI3+S100A7+ proliferating keratinocytes and macrophages had the shortest overall survival. In the analysis of cell-cell interactions, PI3+S100A7+ proliferating keratinocytes and macrophages were found to be involved in highly active pathways that promote differentiation and structure formation, including cytokine receptor interactions, the Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway, and TNF signaling pathway regulation. Further subtyping of fibroblast populations identified four subtypes. The C1 group, characterized by its predominance in tumor tissues, is a subtype enriched with cancer-associated fibroblasts (CAFs), whereas the C3 group is primarily enriched in adjacent non-cancerous tissues and consists of undifferentiated cells. Moreover, the distinct molecular and cellular differences between HPV16- and HPV66-associated tumors were demonstrated, emphasizing the unique tumor-promoting mechanisms and microenvironmental influences driven by each HPV subtype.
CONCLUSIONS
We discovered a heterogeneous population of keratinocytes between tumor and adjacent non-cancerous tissues caused by HPV infection and identified macrophages and specific CAFs that play a crucial role during the early stage in promoting the inflammatory response and remodeling the cancer-promoting TME. Our findings provide new insights into the transcriptional landscape of early-stage CESC to understand the mechanism of HPV-mediated malignant transformation in cervical cancer.
Humans
;
Female
;
Papillomavirus Infections/genetics*
;
Uterine Cervical Neoplasms/genetics*
;
Carcinoma, Squamous Cell/pathology*
;
Keratinocytes/metabolism*
;
Single-Cell Analysis/methods*
;
Tumor Microenvironment/genetics*

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